Provider Demographics
NPI:1326151465
Name:PAUL, FRANK ALLEN (DO)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ALLEN
Last Name:PAUL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6530 LA CONTENTA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284-7313
Mailing Address - Country:US
Mailing Address - Phone:760-820-9229
Mailing Address - Fax:760-820-9228
Practice Address - Street 1:58375 29 PALMS HWY
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-5813
Practice Address - Country:US
Practice Address - Phone:760-365-9305
Practice Address - Fax:866-732-0113
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101011088207P00000X
AZ3473207P00000X
MT12439207PH0002X
NVDO2050207RH0002X
CA20A7307207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PH0002XAllopathic & Osteopathic PhysiciansEmergency MedicineHospice and Palliative Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI55024912011Medicare ID - Type Unspecified